The President's One-Man Death Panel

Health Care: The president recess-appoints a fan of rationing and Britain's National Health Service to direct one-third of American health care. Why does the administration want his views hidden from scrutiny?

'The decision is not whether or not we will ration care  the decision is whether we will ration with our eyes open." That's what Dr. Donald Berwick, President Obama's nominee to head the Centers for Medicaid and Medicare Services, told a National Institutes of Health publication a year ago, when he was just president and CEO of the Institute for Health Care Improvement.

Such views were to be fodder for a stormy confirmation hearing  except none has been scheduled.

Instead, Obama opted to make a recess appointment of Berwick to head CMS, an agency that oversees a third of all health care spending in the U.S. and that will play a major role under ObamaCare in deciding what care is available and who gets it.

Senate Minority Leader Mitch McConnell rightly accused the president of trying to "arrogantly circumvent the American people" with Congress out of town for its annual Fourth of July break.

Berwick could serve through 2011 without Senate confirmation. This sleight of hand involving one-sixth of the American economy and the man who will run one-third of that is the fruit of hope and change?

It is understandable why the administration would want to keep Berwick's views under the radar. He has praised the U.K's National Institute for Health and Clinical Excellence (NICE), which he says has "developed very good and very disciplined, scientifically grounded, policy-connected models for the evaluation of medical treatments from which we ought to learn."

Last year, the Orwellian-named NICE unveiled plans to cut annual steroid injections for severe back pain to 3,000 from 60,000. "The consequences of the NICE decision will be devastating for thousands of patients," Jonathan Richardson of Bradford Hospital's Trust told London's Daily Telegraph.

"It will mean," said Dr. Richardson, "more people on opiates, which are addictive and kill 2,000 a year. It will mean more people having spinal surgery, which is incredibly risky and has a 50% failure rate."

And here we thought the first rule of medicine was to do no harm.

If Berwick wants to imitate Britain's model, perhaps he can explain why breast cancer in America has a 25% mortality rate while in Britain it's almost double at 46%.

Prostate cancer is fatal to 19% of American men who get it; in Britain it kills 57% of those it strikes.

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